Almond Natalie, Deal Allison M, Page Annie, Nyrop Kirsten A, Muss Hyman B
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7305, United States.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7305, United States.
Oncologist. 2025 Jul 4;30(7). doi: 10.1093/oncolo/oyae311.
In a convenience sample of women scheduled for chemotherapy for early-stage breast cancer, we investigated associations of the Center for Disease Control and Prevention's neighborhood-level social vulnerability index (SVI) with pretreatment demographics and patient-reported outcome (PRO) measures (health behavior, function and quality of life, treatment toxicities during chemotherapy).
The SVI Overall score is comprised of 4 themes: socioeconomic, household composition, minority status/language, and household type/transportation, with scores ranging from 0 = lowest to 1 = highest vulnerability neighborhoods. Participant SVI scores were derived from zip codes listed in the patient's address within the electronic medical record (EMR). Associations of study variables with SVI were evaluated using Spearman correlation for continuous variables and Kruskal-Wallis tests for categorical variables.
In a sample of 309 women, the mean age was 56 years (range 23-83) and 75% White. Greater vulnerability SVI Overall score was associated with lower education (P =.02), nonmarriage (P ≤.0001), higher body mass index (P =.03), and prechemotherapy PRO measures such as fewer self-reported walking minutes/week (P ≤.001), history of smoking (P =.02) and alcohol use (P < .001), depression (P =.01), and lower emotional social support (P =.008). During chemotherapy, moderate, severe, or very severe symptoms were associated with greater vulnerability SVI Overall scores for hot flashes (P =.03), arthralgia (P =.02), myalgia (P =.02), peripheral neuropathy (P =.01), edema of limbs (P =.04), and nausea (P <.001).
SVI scores derived from addresses in the patient's EMR can be used to generate information that adds to the patient's social history in ways that are informative for anticipating and monitoring chemotherapy-related toxicities.
在一个为早期乳腺癌安排化疗的便利样本女性群体中，我们调查了美国疾病控制与预防中心的邻里层面社会脆弱性指数（SVI）与化疗前人口统计学特征以及患者报告结局（PRO）指标（健康行为、功能和生活质量、化疗期间的治疗毒性）之间的关联。
SVI总分由4个主题组成：社会经济、家庭构成、少数族裔地位/语言以及家庭类型/交通，分数范围从0（代表最低脆弱性社区）到1（代表最高脆弱性社区）。参与者的SVI分数来自电子病历（EMR）中患者地址列出的邮政编码。使用Spearman相关性分析连续变量，使用Kruskal-Wallis检验分析分类变量，以评估研究变量与SVI之间的关联。
在309名女性样本中，平均年龄为56岁（范围23 - 83岁），75%为白人。较高的脆弱性SVI总分与较低的教育程度（P = 0.02）、未婚（P≤0.0001）、较高的体重指数（P = 0.03）以及化疗前的PRO指标相关，如每周自我报告的步行分钟数较少（P≤0.001）、吸烟史（P = 0.02）和饮酒史（P < 0.001）、抑郁（P = 0.01）以及较低的情感社会支持（P = 0.008）。在化疗期间，中度、重度或非常重度的症状与较高的脆弱性SVI总分相关，这些症状包括潮热（P = 0.03）、关节痛（P = 0.02）、肌痛（P = 0.02）、周围神经病变（P = 0.01）、肢体水肿（P = 0.04）和恶心（P < 0.001）。
从患者EMR中的地址得出的SVI分数可用于生成信息，以一种有助于预测和监测化疗相关毒性的方式补充患者的社会史。
